Water Baptism Application
First Name
Last Name
Mailing Address
Mailing City
Mailing Province
Email Address
Phone Number
Date of Birth
Birthplace
Gender
Male
Female
Father's Full Name
Mother's Full Name
When did you receive Christ as your personal Saviour?
Are you presently walking consistently with the Lord in a personal relationship?
Yes
No
Are you willing to give testimony of your personal faith in Jesus as your Saviour?
Yes
No
What has led you to request water baptism?
Is there a scripture passage or verse you would like to include in your baptism?
Today's Date
Submit